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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659594PMC
http://dx.doi.org/10.5826/dpc.0903a11DOI Listing

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Riga-Fede disease (RFD) is a rare, benign condition marked by traumatic ulceration on the tongue's ventral side in infants. It arises from friction between the tongue and lower incisors during sucking, potentially worsening into a keratinized lesion if the cause is not addressed. This report details the case of a 1-year-6-month-old male with hydrocephalus, cleft palate, corpus callosum dysgenesis, neuropsychomotor developmental delay, and tracheostomy and gastrostomy needs.

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In this case series, we present four unique cases of Riga-Fede disease (RFD), a rare disorder characterized by mucosal trauma as a result of repetitive tongue protrusion against the incisors, leading to the development of a large oral mass/ulceration. Due to the rapid development and growth of these lesions mimicking malignancy, it is important for the general and pediatric otolaryngologist to correctly diagnose and treat this benign disorder. This series highlights the variable clinical presentations, along with comorbidities of RFD, as well as the importance of interdisciplinary care between the pediatric otolaryngologist and pediatric dentist in its management.

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Article Synopsis
  • Riga-Fede disease (RFD) leads to mouth ulcers in infants due to sharp dental edges, causing severe oral bleeding episodes.
  • A 7-month-old boy experienced recurrent bleeding that did not improve with initial treatments until he was seen by a pediatric dentist, who diagnosed RFD and treated him by smoothing his teeth.
  • The case emphasizes the importance of collaborative care in dentistry and highlights that conservative treatments can effectively resolve RFD in healthy children.
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Traumatic Ulcerative Granuloma with Stromal Eosinophilia (TUGSE)/Riga Fede disease is a rare mucosal and submucosal benign reactive inflammatory process, usually involving the tongue. Trauma is believed to be a major factor amongst the multiple pathogenic mechanisms that have been hypothesized in TUGSE. The lesion presents as an isolated indurated or even ulcerated mass, which may mimic, clinically a squamous cell carcinoma (SCC).

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The article presents modern data on the structure of the lingual frenulum in newborns and factors associated with restricted tongue mobility besides the length of the mucosal part of the frenulum. The diversity of these factors dictates to limit the indications for frenectomy in newborns to cases with breastfeeding negative events evaluated and documented by a pediatrician. The assessment protocol should include weight gain but also child and mother position, duration, and comfort of the breastfeeding sessions, as well as breast condition in mother.

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